Bladder CA: Epidemiology & Diagnosis
Risk Factors: Elderly male / smoking / environmental (arsenic) and occupations exposure (aniline dyes) / medications like cyclophosphamide
Mortality has reduced due to :
1. Advances in diagnosing bladder cancer
2. Advances in treatment
Histopathology:
1. 90 % bladder cancers are urothelial cancers
- variety of histologic variants
- High grade and locally advanced
- Micropapillary / plastacytoid / sarcomatoid variants are
most aggressive
2. 6 - 8 % are squamous cell ca
3. 2 % are adenocarcinomas (1/3 rd are urachal in origin)
Clinical presentation: hematuria
Diagnostic Work up:
1. Gross Hematuria: CT Urography + Cystoscopy
2. Microscopic Hematuria
- Low risk: Repeat urinalysis in 6 months or CT ultrasound + Cystoscopy
- Moderate risk: Ultrasound + Cystoscopy
- High risk: CT Urography + Cystoscopy
Urine Cytology: Considered in /initial work up if suspicion of cancer is high
Confirmation: Direct visualization with cystoscopy and transurethral resection of bladder tumor (TURBT)
Reference: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8003397/
Prepared by Dr. Sharad Maheshwari
24.03.2023
Updated:
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